Reyleen Loreto, M.D., on the role of a COPD navigator | CHEST 2026

In this interview with Managed Healthcare Executive, Rayleen Loreto, M.D., discusses navigators for patients with chronic obstructive pulmonary disease (COPD), an element of a quality improvement program she led that reduced the readmission rate of patients with COPD. Loreto, a third-year resident at St. Joseph’s Hospital in Tampa, Florida, presented an abstract about the program at the CHEST 2026 annual meeting last week summarizing research that she and her colleagues did that showed the program reduced 30-day readmission rates among patients hospitalized for chronic obstructive pulmonary disease (COPD) exacerbations from 27.9% before it was implemented to 18.2% afterward.

Over the course of the initiative at the 615-bed hospital, which ran from July 2025 to February 2026 and included 135 COPD discharges, the share of patients who received a COPD navigator consultation rose from 44% to 95%. Patients who had a navigator consultation were readmitted within 30 days at a rate of 20%, compared with 35% among those who did not. Readmissions were also lower among patients with scheduled follow-up (24% vs. 43%).

In this video, Loreto explains that the COPD navigator is a respiratory therapist who keeps a record of every patient admitted for COPD and visits each one to complete the discharge checklist. As a result of the project, the hospital now schedules follow-up appointments while patients are still inpatient, so they are seen within seven days of discharge, rather than only encouraging them to book a visit.

In the same interview, Loreto also discussed the development of a COPD checklist. The first part is handled by a COPD navigator, she said, and covers education about the disease and its symptoms, COPD zones, inhaler education and coordination with case management to identify barriers early in the admission.

The second part is the responsibility of the nursing staff, who reinforce that education and confirm that a pharmacy is listed in the patient’s chart, that medications such as short- and long-acting bronchodilators are prescribed, and that patients set a follow-up appointment with their primary care provider or pulmonologist, Loreto said. Nurses also make sure durable medical equipment, such as oxygen and nebulizers, is available after the patient is discharged.